Grade III bilateral trigger thumbs treated by prolotherapy: a case report

Authors

  • Alif Noeriyanto Rahman Fellow of International Pain Practice, Certified International Pain Sonologist, Educational Program Director of Comprehensive Course in Musculoskeletal Pain Intervention and Regeneration, Faculty of Medicine Universitas Padjadjaran, Orthopaedic and Pain Intervention Center of Sentra Medika Hospital, Depok, Indonesia
  • I Ketut Gede Artha Bujangga Department of Orthopaedic and Traumatology, Klungkung Regional General Hospital, Klungkung, Regency, Bali, Indonesia https://orcid.org/0000-0003-0542-3005
  • Herry Herman Precursor - Comprehensive Course in Musculoskeletal Pain Intervention and Regeneration, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
  • Jordan Sugiarto Department of Orthopaedic and Traumatology, Klungkung Regional General Hospital, Klungkung, Regency, Bali, Indonesia

Abstract

Introduction: Trigger Thumb is a condition that is caused by a thickened A-1 pulley, often secondary to a stenosed tendon sheath. There are several treatment options for trigger thumb, yet the use of prolotherapy to treat Trigger Thumb has not been widely discussed in the literature. Therefore, this study aims to present the case of Bilateral Trigger Thumbs which were treated using Prolotherapy.

Case: A 49-year-old female patient was admitted to the hospital with a complaint of inability to flex his both left & right thumbs two months ago. On physical examination, there was pain and swelling at the base, palmar side of his both thumbs, tender in consistency, and warm. There was a pain in daily activities using his both hands. There wasn’t a history of trauma. The range of motion of both thumbs was decreased. The prolotherapy was given to the right thumb, yet the left thumb was treated by lidocaine injection only. After several treatments using prolotherapy, the right thumb showed better results compared to the left by increasing ROM, decreasing pain level and swelling, and the improving function of the right thumb.

Conclusion: In this case, the right thumb, which was treated with prolotherapy, has shown better results compared to the left thumb which was treated with medication only. We suggest prolotherapy to treat trigger fingers for the other patients in our hospital.

Keywords:

Trigger thumb, Non-Operative, Prolotherapy

DOI

https://doi.org/10.37022/wjcmpr.v4i6.243

Author Biographies

Alif Noeriyanto Rahman, Fellow of International Pain Practice, Certified International Pain Sonologist, Educational Program Director of Comprehensive Course in Musculoskeletal Pain Intervention and Regeneration, Faculty of Medicine Universitas Padjadjaran, Orthopaedic and Pain Intervention Center of Sentra Medika Hospital, Depok, Indonesia

Precursor - Comprehensive Course in Musculoskeletal Pain Intervention and Regeneration, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia

Herry Herman, Precursor - Comprehensive Course in Musculoskeletal Pain Intervention and Regeneration, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia

Director of Comprehensive Course in Musculoskeletal Pain Intervention and Regeneration, Faculty of Medicine Universitas Padjadjaran, Department of Orthopaedic and Traumatology Hasan Sadikin General Hospital Faculty of Medicine Padjadjaran University, Bandung, West Java

References

Clapham PJ, Chung KC. A Historical Perspective of the Notta’s Node in Trigger Fingers. J Hand Surg Am. 2009;34(8):1518–22. Available from: https://doi.org/10.1016/j.jhsa.2009.04.041

Matthews A, Smith K, Read L, Nicholas J, Schmidt E. Trigger finger: An overview of the treatment options. J Am Acad Physician Assist. 2019;32(1):17–21. Available from: https://doi.org/10.1097/01.JAA.0000550281.42592.97

Salter RB. 1999. Textbook of Disorders and Injuries of the Musculoskeletal System. Section II: Musculoskeletal Disorders-General and Specific. Third Edition. USA: Lippincott Williams & Wilkins. Pg 158-59.

Dala-Ali BM, Nakhdjevani A, Lloyd MA, Schreuder FB. The efficacy of steroid injection in the treatment of trigger finger. Clin Orthop Surg. 2012;4(4):263–8. Available from: https://doi.org/10.4055/cios.2012.4.4.263

Soldati G, Iacconi P. Sonographic appearance of ARDS: Letter: Ref. Tsubo T, Yatsu Y, Suzuki A, Iwakawa T, Okawa H, Ishihara H, Matsuki A (2001) Daily changes of the area of density in the dependent lung region - Evaluation using transesophageal echocardiography. Intensive Care Med 27:1881-1886 [5]. Intensive Care Med. 2002;28(11):1675. Available from: https://doi.org/10.1007/s00134-002-1484-2

Abe Y, Tominaga Y. Paradoxical extension phenomenon of the little finger due to repetitive trauma to the palm. Hand Surg. 2012;17(2):255–7. Available from: https://doi.org/10.1142/S0218810412720288

Catalano LW, Alton Barron O, Glickel SZ, Minhas S V. Etiology, evaluation, and management options for the stiff digit. J Am Acad Orthop Surg. 2019;27(15): E676–84. Available from: https://doi.org/10.5435/JAAOS-D-18-00310

Solomon, L., Warwick, D., Nayagam, S., & Apley, A. G. (2017). Apley's system of orthopedics and fractures (10th ed.). London: Hodder Arnold. Pg 439-40.

Chapman T, Ilyas AM. Pyogenic Flexor Tenosynovitis: Evaluation and Treatment Strategies. J Hand Surg Am [Internet]. 2019;44(11):981–5. Available from: https://doi.org/10.1016/j.jhsa.2019.04.011.

Everding NG, Bishop GB, Belyea CM, Soong MC. Risk factors for complications of open trigger finger release. Hand. 2015;10(2):297–300. Available from: https://doi.org/10.1007/s11552-014-9716-9

Rabago D, Nourani B, Weber MJ. Prolotherapy for Chronic Musculoskeletal Pain [Internet]. Fourth Edition. Integrative Medicine: Fourth Edition. Elsevier Inc.; 2018. 1047-1053.e2 p. Available from: http://dx.doi.org/10.1016/B978-0-323-35868-2.00112-2.

Doyle JR. Palmar and digital flexor tendon pulleys. Clin Orthop Relat Res. 2001;383(383):84–96. Available from: https://doi.org/10.1097/00003086-200102000-00011

Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. Clin Med Insights Arthritis Musculoskelet Disord. 2016;9:139–59. Available from: https://doi.org/10.4137/cmamd.s39160

Moshrif A, Elwan M. The effect of addition of buffered dextrose 5% solution on pain occurring during local steroid injection for the treatment of plantar fasciitis: A randomized controlled trial. Muscles Ligaments Tendons J. 2019;9(4):525–30. Available from: https://doi.org/10.32098/mltj.04.2019.06

Published

2022-11-29
Statistics
Abstract Display: 484
PDF Downloads: 290
Dimension Badge

How to Cite

1.
Grade III bilateral trigger thumbs treated by prolotherapy: a case report. World Journal of Current Med and Pharm Research [Internet]. 2022 Nov. 29 [cited 2026 Jan. 27];4(6):143-6. Available from: https://www.wjcmpr.org/index.php/journal/article/view/243

Issue

Section

Case Reports

How to Cite

1.
Grade III bilateral trigger thumbs treated by prolotherapy: a case report. World Journal of Current Med and Pharm Research [Internet]. 2022 Nov. 29 [cited 2026 Jan. 27];4(6):143-6. Available from: https://www.wjcmpr.org/index.php/journal/article/view/243